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Wound Care: 3 Medicare contractor policies compared

3 Local Coverage Determinations in the current Medicare Coverage Database export carry the title "Wound Care", between them covering 51 states and territories. 3 of them have a billing and coding article with a diagnosis list, ranging from 1 to 1,362 covered ICD-10-CM codes. 1 records a source policy it was derived from. The table below is the fastest way to see which version governs a given state and how far the versions have drifted.

QuickIntell editorial content · Legacy registry date · Review not verified

Data effective
Policies with this title
3
States covered
51
Versions with a coded article
3
Revision dates
2020-07-23 to 2025-03-27

Every version by contractor

Open a version for its full policy text, contracts, codes and related NCDs. Covered codes are the count of ICD-10-CM codes in the version's billing and coding article; a dash means the export attaches no coded article.

Local Coverage Determinations titled "Wound Care"
LCDContractorStatesRevisedCovered codesPolicy words
L35125Novitas Solutions, Inc.AR CO DC DE LA MD MS NJ NM OK PA TX2020-07-2312,233
L37166First Coast Service Options, Inc.FL PR VI2020-07-2312,235
L37228Wisconsin Physicians Service Insurance CorporationAK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MO MS MT NC ND NE NH NJ NM NV OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY2025-03-271,3621,354

Lineage

The Medicare Coverage Database records the source policy a determination was derived from: L35125 from L32687. A shared source explains why the opening paragraphs read alike; the revision dates and the diagnosis counts above show where the versions have since parted.

How to use the comparison

Start from the state where the service is furnished and open that contractor's version; its billing and coding article carries the diagnosis codes the claims system will test. For a group that bills in several jurisdictions, the version with the smallest covered list is the safe common denominator for pre-service review, and the version with the largest list shows what documentation can support an appeal elsewhere. The L37228 version is the one most searched for this title; the LCD lookup guide explains how jurisdictions are assigned, and the LCD hub lists every topic that more than one contractor has written.

Frequently asked questions

Why are there 3 LCDs called "Wound Care"?

Each Medicare Administrative Contractor writes its own Local Coverage Determination for its jurisdiction. 3 contractors publish a policy with this title covering 51 states; they often start from one contractor's text and then revise separately, so dates, criteria and diagnosis lists differ by jurisdiction.

Which "Wound Care" LCD applies to my claim?

The one written by the contractor that processes the claim: the A/B MAC for the state where the service is furnished, or the DME MAC region for equipment. The table lists each policy's states; open the policy for that jurisdiction and its billing and coding article.

How different are the diagnosis lists?

Among the 3 versions with a billing and coding article, the covered ICD-10-CM list ranges from 1 to 1,362 codes. A diagnosis accepted under one contractor can deny under another, which is the most common cause of coverage denials for multi-state groups.

When were these policies last revised?

Revision effective dates run from 2020-07-23 to 2025-03-27. A claim is judged against the version in force on the date of service.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

Policy metadata and code counts are reproduced from the CMS Medicare Coverage Database export as an operational reference. Verify against the current LCD and article on cms.gov before billing. Not legal, clinical or billing advice.